- 8 Important Things to Do About Depression
- 10 Benefits of Depression TreatmentTreating your depression can do more than just boost your mood.
- Is It Depression or the Blues?Find out how to tell when you need help, and what to do.
- What Stops You From Seeing a Doctor?How to overcome common reasons people avoid asking their doctor about depression.
- Finding a Doctor & TherapistWhy it's important to have both when treating depression.
- Facts About AntidepressantsFind out what's a myth and what's a fact when it comes to depression medication.
- Depression Treatment TipsHow you can help your antidepressant work better.
- Managing Pain and DepressionHow pain and depression are connected.
- Cognitive Therapy for DepressionAre negative thoughts dragging you down? See how cognitive therapy can help.
Are you struggling with depression? Are you getting treatment for it? If not, you're not alone. About two-thirds of people with major depression never seek appropriate treatment, and the consequences can be devastating: personal suffering, missed work, broken marriages, health problems and, in the worst cases, death.
The World Health Organization ranks depression as one of the world's most disabling diseases. Yet with treatment, 70% of people with clinical depression can improve, often in a matter of weeks.
So what keeps us from seeking help? "It's hard to find out from folks why they are not coming [for treatment], because if they are not coming, they can't tell us," says Kate Muller, PsyD. "But when they do finally get to our offices, they can certainly speak about the things that might have kept them from coming initially."p>
Major Depression: Reasons Why People Avoid Treatment
If you feel depressed and are trying to deal with it on your own, see if any of these reasons ring true to you. If they do, then follow the experts' advice to get the help you need.
If I give it time, I'll snap out of it. Although a case of the blues passes with time, clinical depression may linger indefinitely if not treated, says Erik Nelson, MD. People can't just snap out of being depressed. Sometimes depression has a biological cause. And like other medical conditions, it often requires treatment to control or heal it
Waiting for depression to simply pass can be harmful for a number of reasons. For one, depression that goes untreated may become more severe, Nelson says. The longer the delay in treatment, the more difficult it may be to control, and the more likely it is to recur when treatment is stopped. There also is growing evidence that untreated depression can contribute to or worsen other medical problems. "Heart disease is the one that has been most linked to depression, but research also suggests a link between depression and metabolic issues such as obesity, diabetes, and diseases such as Alzheimer's and cancer," Nelson says.
Expert advice: Don't allow depression to linger. Speak to your doctor. If you find it difficult to seek treatment for a mental disorder, remember that treatment for it may help prevent serious health conditions like heart disease.
I don't want to take antidepressants. "Sometimes I think what keeps people from coming in to see us is that they're afraid they'll have to take a pill," Muller says. "They think, ‘I don't want to take a pill for the rest of my life.'"
Although antidepressants are effective against depression, treatment for depression doesn't always involve medication. "We have psychotherapies these days that are as effective, so if you are depressed, medication may not be the only option," Muller says.
"Cognitive-behavioral therapy is a form of talk therapy that focuses on the here and now -- helping you look at your emotions, thoughts, and behaviors to try to improve your quality of life and reduce your depression," she says. "We know that it may work as well as medications in the short term, but may also last longer."
Expert advice: See a therapist (psychologist, psychiatrist, or social worker) as well as your regular doctor. If you do need a medication, it most likely won't be for life. Learn all you can and don't rely on stories you have heard from others who have taken antidepressants, Muller says. Every person reacts a little differently to them.
I don't feel sad all the time. Why do I need treatment for depression? You don't need to feel sad or cry all day to be clinically depressed. Often people with depression see their primary care doctors for problems such as muscle pain, sleeping problems, or fatigue, not knowing those are signs of depression, Nelson says. Sometimes these symptoms accompany sadness; other times they don't.
"There is also so-called ‘masked depression' -- when, for whatever reason, people don't feel in touch with a sense of sadness or abnormal mood," he says. "They may be more likely to report something like apathy, blunted mood, or not feeling like themselves."
In these cases, a doctor may diagnose depression based on other symptoms, particularly decreased interest in or loss of pleasure from favorite activities.
Expert advice : If you are having symptoms such as fatigue, muscle pain, or loss of interest in activities you love, don't rule out depression as a cause. See your doctor.
I'm embarrassed to talk to my doctor about it. "The shame of having a mental health problem keeps folks from seeking help or even talking about suffering from depression," says Bob Livingstone, author of The Body Mind Soul Solution: Healing Emotional Pain Through Exercise. But depression is nothing to be ashamed of. It is a medical condition, much like diabetes or high cholesterol, which requires treatment.
It is also a very common condition. Depressive disorders affect nearly 19 million people in the U.S. every year -- regardless of gender, age, race, religion, sexuality, income or education. So there's a good chance your doctor won't hear anything from you that she hasn't heard many times before.
Expert advice: Remember that virtually everyone experiences depression at some point, and your doctor will not repeat anything that you share during an office visit. Still, if speaking to your own doctor is embarrassing, find out if your health insurance has someone you can speak with first by phone. If you don't have insurance coverage for mental health, check out mental health services in your community.
I'm afraid of having to talk about painful subjects in therapy. "Depressed people avoid treatment for fear of having to undergo a probing examination of their psychological pain," says Joe Wegmann, a licensed clinical social worker in Metairie, La.
"They have a fear of opening it all up –- ‘I don't want to go there,'" Kate Muller says. Unfortunately, in some cases, getting into painful discussions is necessary for healing, she says. "But in other cases, it doesn't have to be as deep or scary as you might think. A good therapist understands what is like for someone to open up to a stranger and will guide you through that process. He won't push you to open up too quickly or at a level you are not comfortable with."
Expert advice: Find a therapist you feel comfortable with and ask him as many questions as he asks you, Muller says. Find out what therapy will be like. Although painful discussions may be necessary in time, your therapist cannot force you. What you reveal is up to you.
Reviewed by Joseph Goldberg, MD on September 14, 2012
© 2012 WebMD, LLC. All rights reserved.
Important Safety Information About Cymbalta®
The most important information you should know about Cymbalta:
Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away or seek emergency help if you have new or worsening depression symptoms; unusual changes in behavior, such as agitation, irritability, impulsivity, or restlessness; or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.
Cymbalta may be associated with serious side effects. Call your healthcare provider right away or seek emergency help if you experience any of the following:
- Itching, right upper-belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of life-threatening liver problems. Severe liver problems, some fatal, have been reported
- High fever, confusion, stiff muscles, muscle twitching, or racing heart rate, which may be signs of serotonin syndrome, a potentially life-threatening condition
- Abnormal bleeding, especially if Cymbalta is taken with aspirin, NSAID pain relievers (like ibuprofen or naproxen), or blood thinners
- Serious, possibly life-threatening skin reactions, which may include skin blisters, peeling rash, mouth sores, hives, or other allergic reactions
- Abnormal mood (mania), which may include greatly increased energy, severe trouble sleeping, racing thoughts, talking more or faster than usual, and reckless behavior
- Seizures or convulsions
- Decreased blood pressure upon standing, which can cause dizziness or fainting, mostly when first starting or increasing the dose. Cymbalta can also increase blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
- Headache, weakness or feeling unsteady, confusion, problems concentrating, or memory problems, which may be signs of low sodium levels in the blood. Elderly people may be at greater risk
- Problems with urination, including decreased flow or inability to pass any urine
- Changes in appetite or weight. Children and adolescents should have height and weight monitored
Do not stop Cymbalta or change your dose without talking to your healthcare provider, as you could have side effects.
Cymbalta is not for everyone. Do not take Cymbalta if you:
- Are taking or have recently taken a monoamine oxidase inhibitor (MAOI), including the antibiotic linezolid, or Mellaril® (thioridazine). Taking Cymbalta close in time to these medicines can cause serious or even life-threatening side effects
- Have uncontrolled narrow-angle glaucoma (eye pain due to increased eye pressure)
Before taking Cymbalta, talk with your healthcare provider:
- About all your medical conditions, including
- kidney or liver problems, heart problems, or high blood pressure
- glaucoma or diabetes (Cymbalta may worsen diabetes or a type of glaucoma)
- seizures/convulsions, mania, or if you have bipolar disorder
- if you have ever had or been told you have bleeding problems, low sodium levels in your blood, or delayed stomach emptying
- About all prescription and over-the-counter medicines and supplements you take or plan to take, including
- antibiotics or medicines for migraine, mood, or psychotic disorders, to avoid a potentially life-threatening condition when taken with Cymbalta
- aspirin, NSAID pain relievers, or blood thinners, because they may increase risk for bleeding
- About your alcohol use (you should not take Cymbalta if you drink heavily)
- If you are pregnant or plan to become pregnant during therapy or are breast-feeding
Most common side effects of Cymbalta (this is not a complete list):
Nausea, dry mouth, sleepiness, fatigue, constipation, decreased appetite, increased sweating, dizziness. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Other safety information about Cymbalta:
- Cymbalta may cause sleepiness and dizziness. Until you know how Cymbalta affects you, you shouldn't drive a car or operate hazardous machinery
- People age 65 and older who took Cymbalta reported more falls, some resulting in serious injuries
How to take Cymbalta
Take Cymbalta exactly as directed by your healthcare provider. Do not open, break, or chew capsule; swallow it whole. Cymbalta is available by prescription only.
DD CON ISI 02OCT2012
©Lilly USA, LLC 2013. All rights reserved.
Cymbalta is a registered trademark of Eli Lilly and Company.
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